Healthcare Provider Details

I. General information

NPI: 1902721822
Provider Name (Legal Business Name): INTEGRATIVE MEDICAL INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3042 N FEDERAL HWY STE 305
FORT LAUDERDALE FL
33306-1400
US

IV. Provider business mailing address

3042 N FEDERAL HWY STE 305
FORT LAUDERDALE FL
33306-1400
US

V. Phone/Fax

Practice location:
  • Phone: 954-526-2066
  • Fax: 888-291-8365
Mailing address:
  • Phone: 954-526-2066
  • Fax: 888-291-8365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN D RHODEN
Title or Position: MANGER
Credential: RN
Phone: 954-526-2066